Provider Demographics
NPI:1326700303
Name:BLUE HEART HOME HEALTHCARE
Entity Type:Organization
Organization Name:BLUE HEART HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:517-719-3880
Mailing Address - Street 1:3973 W BELLEVUE HWY
Mailing Address - Street 2:
Mailing Address - City:OLIVET
Mailing Address - State:MI
Mailing Address - Zip Code:49076-9493
Mailing Address - Country:US
Mailing Address - Phone:517-719-3880
Mailing Address - Fax:
Practice Address - Street 1:3973 W BELLEVUE HWY
Practice Address - Street 2:
Practice Address - City:OLIVET
Practice Address - State:MI
Practice Address - Zip Code:49076-9493
Practice Address - Country:US
Practice Address - Phone:517-719-3880
Practice Address - Fax:269-280-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health